Diabetes is a global public health issue. The county medical consortium integrates medical resources within the county to improve the efficiency of chronic disease management and service accessibility, and reduce unnecessary hospitalizations.

To evaluate the impact of establishing a compact county medical consortium on the utilization and cost control of diabetes inpatient services, providing evidence for optimizing chronic disease hierarchical diagnosis and treatment policies.

In June 2025, diabetes inpatient case data from January 2016 to June 2020 were collected from the hospital discharge summary systems of Yangxi County, Guangdong Province (which implemented medical consortium reform in November 2017) as the intervention group, and Yangchun City (which implemented the reform in April 2020) as the control group. Interrupted Time Series Analysis (ITS) was adopted, and changes in hospitalization volume, readmission volume, average length of stay, and costs were analyzed through Ordinary Least Squares (OLS) regression, Poisson regression, and Generalized Linear Model (GLM).

After the implementation of the medical community, the intervention group showed a significant decrease in hospitalization volume (immediate effect β=-52.825, P=0.008); however, no improvement was observed in readmission volume (β=-3.978, P=0.271). The control group showed a significant increase in hospitalization volume (immediate effect β=57.473, P<0.001), and readmission volume also exhibited an increasing trend (immediate effect β=5.485, P=0.033). The average hospitalization cost in the intervention group increased slightly (long-term effect β=0.039, P<0.001), whereas the control group showed a downward trend in average hospitalization cost (long-term effect β=-0.010, P<0.001). No significant changes were observed in the average length of stay in either the intervention group or the control group (P=0.256 and P=0.101, respectively).

The medical consortium effectively diverted mild diabetes cases through resource integration. reducing unnecessary hospitalization services, but no significant effects have yet been observed in terms of medical service quality and cost control. It is recommended to establish a synergistic mechanism integrating "payment reform - capacity building at the primary level - digital empowerment" to improve hierarchical management of chronic diseases.

糖尿病是全球性公共卫生问题，县域医共体通过整合县域内医疗资源，进而改善慢性病管理效率与服务可及性，减少不必要的住院。

评估紧密型县域医共体建设对糖尿病住院服务利用及费用控制的影响，为优化慢性病分级诊疗政策提供依据。

2025年6月，以广东省阳西县（2017年11月实施医共体改革）为试验组，以阳春市（2020年4月实施医共体改革）为对照组，收集两地住院病案首页系统2016年1月—2020年6月糖尿病住院病例数。采用中断时间序列分析（ITS），通过普通最小二乘法（OLS）回归、泊松回归、广义线性模型（GLM）分析住院量、再入院量、平均住院天数及费用的变化趋势。

医共体实施后，试验组住院量显著下降（即时效应β=-52.825，P=0.008），但再入院量无明显改善（β=-3.978，P=0.271）；对照组住院量出现显著增加（即时效应β=57.473，P<0.001），再入院量也有增加趋势（即时效应β=5.485，P=0.033）。试验组平均住院费用略有上升（长期效应β=0.039，P<0.001），对照组平均住院费用呈现下降趋势（长期效应β=-0.010，P<0.001）。试验组和对照组平均住院天数均未见明显变化（P值分别为0.256、0.101）。

县域医共体建设可有效分流糖尿病轻症患者，减少不必要的住院服务，但在医疗服务质量和费用控制方面还未发现明显效果。建议构建"支付改革-能力下沉-数字赋能"的协同机制，促进慢性病分级管理。